Dysfunctional uterine bleeding differential diagnosis: Difference between revisions
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|[[Endometrial hyperplasia]] | |[[Endometrial hyperplasia]] | ||
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*Exogenous | *Exogenous [[estrogen]] | ||
*Excess of endogenous estrogen | *Excess of endogenous estrogen | ||
*DUB (dysfunctional uterine bleeding) is a diagnosis of exclusion | *DUB (dysfunctional uterine bleeding) is a diagnosis of exclusion | ||
| Line 54: | Line 54: | ||
|Risk factors include: | |Risk factors include: | ||
*Type 1 diabetes | *[[Type 1 diabetes]] | ||
*Type 2 diabetes | *[[Type 2 diabetes]] | ||
*Obesity | *[[Obesity]] | ||
*Hereditary | *[[Hereditary]] factors | ||
|PCOS may initially be suspected upon physical examination, commonly presenting with [[hirsutism]] and [[weight gain]]. Confirmation requires [[FSH]]/[[LH]] level abnormalities as well as multiple [[ovarian cysts]] seen on [[ultrasonography]]. | |PCOS may initially be suspected upon physical examination, commonly presenting with [[hirsutism]] and [[weight gain]]. Confirmation requires [[FSH]]/[[LH]] level abnormalities as well as multiple [[ovarian cysts]] seen on [[ultrasonography]]. | ||
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===Other Causes=== | ===Other Causes=== | ||
*Endometrioma | *[[Endometrioma]] | ||
*Hyperprolactinemia | *[[Hyperprolactinemia]] | ||
*Hypo- or [[Hyperthyroidism]] | *Hypo- or [[Hyperthyroidism]] | ||
*Hypothalamic lesion | *Hypothalamic lesion | ||
*Medications (e.g., [[Norepinephrine]]) | *Medications (e.g., [[Norepinephrine]]) | ||
*Nonuterine bleeding | *Nonuterine bleeding | ||
*:*Rectal | *:*[[Rectal bleeding|Rectal]] | ||
*:*Urinary | *:*Urinary | ||
*:*Vaginal | *:*[[Vaginal bleeding|Vaginal]] | ||
*:*Cervical | *:*Cervical | ||
*Pelvic infection | *Pelvic infection | ||
*[[ | *[[Anorexia Nervosa]], Nutritional status (Very low caloric intake) & intense exercise | ||
*Immature hypothalamic-pituitary-ovarian axis | *Immature hypothalamic-pituitary-ovarian axis | ||
*Peri-menopause | *Peri-menopause | ||
* | *Psychological distress <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> | ||
==References== | ==References== | ||
Revision as of 08:51, 2 March 2022
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Dysfunctional uterine bleeding Microchapters |
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Differentiating Dysfunctional uterine bleeding from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Arooj Naz ,Vishnu Vardhan Serla M.B.B.S. [2]
Overview
There are many differential diagnosis' for dysfunctional uterine bleeding, many of them resulting in abnormal presentation of bleeding. Some prevalent conditions include anatomical or structural defects, coagulation disorders, pregnancy related complications, endometrial cancer and hyperplasia, as well as Polycystic Ovarian Syndrome.
Differential Diagnosis
| Condition | Common Underlying Causes | Workup |
|---|---|---|
| Anatomic or structural lesions |
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Pelvic or transvaginal Ultrasonography |
| Coagulationdisorders |
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Coagulation studies; PT, aPTT, Bleeding Time, and clotting factor studies |
| Pregnancy complications | B-hCG should be the first test to detect the presence of pregnancy. Visualization of the defect requires pelvic or transvaginal ultrasonography | |
| Endometrial cancer[1] | Risk factors include:
|
Upon transvaginal ultrasonography, endometrial cancer will present as a thicked endometrial strip. Confirmation requires an endometrial biopsy. |
| Endometrial hyperplasia |
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Endometrial hyperplasia realted changes may be seen on ultrasonography. Obtaining a detailed history of medication use may be of assistance in coming to a diagnosis. |
| Polycystic Ovarian Syndrome (Stein Leventhal Syndrome) [2] | Risk factors include: | PCOS may initially be suspected upon physical examination, commonly presenting with hirsutism and weight gain. Confirmation requires FSH/LH level abnormalities as well as multiple ovarian cysts seen on ultrasonography. |
Other Causes
- Endometrioma
- Hyperprolactinemia
- Hypo- or Hyperthyroidism
- Hypothalamic lesion
- Medications (e.g., Norepinephrine)
- Nonuterine bleeding
- Pelvic infection
- Anorexia Nervosa, Nutritional status (Very low caloric intake) & intense exercise
- Immature hypothalamic-pituitary-ovarian axis
- Peri-menopause
- Psychological distress [3]
References
- ↑ "StatPearls". 2022. PMID 30252237.
- ↑ Sirmans SM, Pate KA (2013). "Epidemiology, diagnosis, and management of polycystic ovary syndrome". Clin Epidemiol. 6: 1–13. doi:10.2147/CLEP.S37559. PMC 3872139. PMID 24379699.
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016